In Emerg, as part of an exam in preparation for sedation, a level 2 heart murmur was heart (left pulmonary). Max is 13 months.
Tested at 8 weeks, no murmur found.
- why would this not have been picked up prior by his normal vet?
- will this get worse?
- Will he be handicapped?
- How will this affect any future sedation?
- how common is this?
Dr. Marie replied:
Gosh, Max keeps finding ways to make us worry.
I have had several cases (mostly Golden Retriever for some reason) where I could not hear a heart murmur, but I could hear one when the dog was sedated. There are a few possible reasons for this. It's possible that the sedation causes a mild decrease in blood pressure that changes the dynamics of how the blood flows through the heart and makes a murmur more likely. It's also possible that the sedation caused the heart rate to decrease and some murmurs may be more evident at a slower heart rate.
There are some dogs that can have murmurs that come and go. I may only hear them every third or fourth exam.
We grade murmurs on a scale of 1-6. Usually a grade 2 murmur in a young dog is nothing to worry about.
The only way to know for sure what is causing the murmur and how much of a concern it is would be to have an ultrasound done of his heart. This usually has to be done by a specialist as heart ultrasounds are a little bit more technically challenging that an abdominal ultrasound.
I have LOTS of patients in my practice that have a low grade murmur like this and never ever have any problems with their heart. This will likely be the case for Max.
It's very unlikely to cause problems with any future sedation or anesthesia.
I would be surprised if it got worse. However, if this were my patient I would likely be requesting an exam every six months to listen to see if the murmur is getting louder. If it was getting louder, or if he was developing signs of heart disease such as coughing or fainting then I would definitely want to do a heart ultrasound.
To summarize, I'm not too concerned about the murmur.
Hope you get some answers on the vomiting soon though.
Dr. Marie.
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Customer reply:
At the time of the exam max was in a very hyper state. Could this influence the results?
Dr. Marie replied:
It might. If a dog is excited then there are changes in blood pressure and heart rate and this can possibly cause a murmur that was previously undetectable to become noticeable.
Customer reply:
My regular vet couldn't hear any murmur. To be certain an ultrasound was taken by an ultrasound specialist. There were no abnormalities found. Thank God.
Dr. Marie replied:
This is good news!
Customer reply:
It's such a relief to return back to vomit
Customer reply:
Recall max threw up every four days on blue buffalo. Since Sunday he's been on four cups of hamburger and rice. Stool mostly hard but end part mushy.
Sunday I feed him fifteen kibbles per meal of medical gastro to transition. Sund at 9 pm he throws up.
Ulcer?
Sensitivity to chicken? He also eats hypo chicken treats and peanut butter
Obstruction?
Dr. Marie replied:
Hmmm...frustrating. It really shouldn't be a food issue as medical gastro should not cause a dog to vomit.
An ulcer should cause tiny black flecks (looking like coffee grounds) in the vomit.
An obstruction probably should have shown up on the xrays. Did the vets do a barium series of xrays? If not, this may be the next step.
You may want to ask your vet about the possibility of a condition called helicobacter. This is a type of bacteria that can affect the stomach and cause intermittent vomiting. It can be hard to diagnose. Sometimes, if I suspect this I will do a trial treatment. It is usually a combination of metronidazole, famotidine and a penicillin type antibiotic at the same time (sometimes there are other medicines thrown into the mix.)
Customer reply:
We never took x rays due to suspected murmur. It's so weird it began right after he went off Skin support food
Dr. Marie replied:
The xrays are likely the next best step then. But, ultimately your vets have more information than I do and they will be the best ones to advise you on this.
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Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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